FAMILY HEALTH MATTERS: An ounce of prevention is worth a pound of cure

STUART - Benjamin Franklin may have had a crystal ball when he said, "An ounce of prevention is worth a pound of cure."

Nov. 14 through 18 is Get Smart about Antibiotics Week, and with the onset of cold and flu season, this is an important and relevant topic.

Penicillin, the first traditional antibiotic, was actually accidentally discovered in the 1920s and not recognized and used until the 1940s. Unfortunately, it has become, along with many other antibiotics, of limited usefulness in the modern era due to what is known as bacterial resistance.

There are many theories on this topic, but without question the largest contributing factor is antibiotic overuse.

When I started in practice more than 20 years ago, it was common to prescribe antibiotics to patients with the flu and common colds, in hopes of preventing a bacterial infection such as sinusitis from developing. With the rapid rise of bacterial resistance since the 1990s, and especially in the last decade, several national guidelines have recommended against this, but have met with relatively little acceptance by both patients and physicians.

A recent article in the October issue of The Journal of Family Practice on this topic gives more evidence about the folly of this practice.

According to the article, each year more than 30 million Americans are diagnosed with sinusitis, although less than 2 percent of these cases are thought to be bacterial.

Center for Disease Control (CDC) guidelines for the diagnosis of bacterial sinusitis include symptoms that last 7 days or more, with those affected having symptoms less than a week not likely to have a bacterial infection.

However, the CDC guidelines for sinusitis include very nonspecific signs and symptoms, somewhat limiting their usefulness in trying to differentiate a bacterial from a viral infection. At any rate, more than 80 percent of patients diagnosed with acute sinusitis are given antibiotic prescriptions, even though 80 percent of people with sinusitis improve within 2 weeks even without treatment.

This is important because not only does overuse of antibiotics contribute to the high rate of bacterial resistance, but side effects of antibiotics lead to about 140,000 ER visits per year.

This current study looked at patients with moderate to severe sinusitis, treated either with or without antibiotics. The findings showed no difference between the amoxicillin or control group in outcome, except that on day 7 only the antibiotic group did report symptom improvement.

Antibiotics did not shorten the duration of illness, prevent relapse or recurrence, or improve satisfaction with treatment.

Most people today are aware of the problems associated with antibiotic resistance, especially with the outbreaks both nationally and locally of significant multidrug resistant infection such as MRSA, or the "flesh eating bacteria."

Doctors can help by reminding patient of the side effects of antibiotics and the natural course of sinusitis. With this evidence, hopefully most patients will also be receptive to this change in practice.

The old saying, "a cold will get better in seven days if you treat it or a week if you don't," still holds true today.

For more information about treatment and prevention of colds and the flu, speak to your family physician or call me.

Family physician Dr. Jeffrey Gorodetsky and the staff of the JSG Medical Practice are located in Stuart. For more information on this topic and other family health & medical issues, visit http://www.jsgmedical.com or call 772 223-4504.

This story is contributed by a member of the community and is neither endorsed nor affiliated with TCPalm.